Thoughts/opinions on D&C- ultrasound showed empty sac

alphalambda · July 2009

Hey ladies,

I have had two previous miscarraiges and RPL testing, which revealed I have a blood clotting disorder. I went on Lovenox immediately.

I am now 7.5 weeks pregnant. The 6 week ultrasound showed only a sac and nothing else. The 7.5 week ultrasound showed the same thing. My Dr. has recommended a D&C. They do not think that this had anything to do with the Lovenox. I have scheduled it for Friday, but am starting to have second thoughts. They said that they will do an ultrasound right before the procedure to confirm the diagnosis. But, should I just wait to miscarry on my own? Is that better for my body? I did with the previous two at 5 weeks. I am just so confused and don't want to make the wrong decision. I was in such shock today that I didn't ask all of the questions that are now running through my mind.

I guess a good thing about the D&C is that they can do testing to try to get some answers. But, will we have to wait longer after a D&C to try again? I also worry about the risks invovled.

I know you ladies cannot make this decision for me, but I would like your thoughts/experiences.

DavezWife · July 2009

I am soooo very sorry.

I'm a little confused, and maybe it's because you were not able to fully listen. If there's nothing in the sac, there's nothing to test. They have to be able "grow" the tissue to check for chromosomal issues. I also see no point in doing a D&C if, again, there's nothing in there. You have a lining to shed, but if it's not supporting what (used to be) a fetus, in theory there's not much in there in the 1st place.

By 7.5 weeks you should see a heartbeat for sure. Were they able to measure anything?

I'm suspecting you had a blighted ovum or just never got past that initial few moments of pregnancy. Personally, I would wait it out and see if you just flush it all naturally, to avoid risking your lining, etc. but the whole "D&C or not to D&C" is a very personal choice, that depends on many factors, IMO. It is advisible you wait 2-3 cycles post d&c to try again, but many new studies are saying you can try sooner if it was a loss earlier, not requiring surgery.

You can always call back your doc and say "I just didn't hear what you said" and they should be able to give you more specifics about your appt.

Again, very very sorry.

LMichelleG · July 2009

First off, I am sooo sorry for your loss. It's definitely not something I'd wish on anyone. So please take time for yourself. Secondly, I can assure you as well that the lovenox did not cause the m/c. My guess is you were diagnosed with having Factor V Leiden (I have it as well). So you are at a higher risk for bloot clots, the lovenox reduces that risk tremendously and helps keep you from m/cing due to blood clots, but its not linked to m/c.

As for waiting to miscarry on your own. It's such a difficult decision, one that I was faced with 2 weeks ago. I found out at 9 weeks that the baby had stopped developing at 6 weeks (empty sac as well). My body never passed it so I opted for the D&C and was glad I did. It was a fairly painless experience for me.

My only question is, have they run blood tests? Your hcg levels are supposed to double every 48-72 hours. After 6 days of blood tests and 3 ultrasounds (all confirming the baby had stopped developing) I decided to wait one week to see if my body would pass it, but ended up going in for the D&C (which turned out to be quite painless for me).

Again I'm SOOO sorry you are dealing with this. My prayers are with you.

alphalambda · July 2009

Thank you, Davezwife. The Dr. did not use the term blighted ovum, but I am also guessing that it what it is. The Dr. said that the sac was completely empty. He showed it to us and I could see the same thing. He still said that they could do the chromosome testing. I think I will call my nurse back and ask more details. Thanks again.

alphalambda · July 2009

LMichelleG:

My only question is, have they run blood tests? Your hcg levels are supposed to double every 48-72 hours. After 6 days of blood tests and 3 ultrasounds (all confirming the baby had stopped developing) I decided to wait one week to see if my body would pass it, but ended up going in for the D&C (which turned out to be quite painless for me).

Again I'm SOOO sorry you are dealing with this. My prayers are with you.

They have run blood tests. They did three rounds of hcg testing and they were doubling as they should. They did an ultrasound at 6 weeks showing an empty sac and then another at 7.5 weeks that showed an empty sac. No further blood testing has been done. I have contemplated waiting another week to see if things will happen on their own. I am starting to cramp a little bit now, so I am sort of hoping that it will start on its own today or tomorrow and I won't have to make this decision.

KateAndMark · July 2009

I'm really sorry you are going through this.

Personally, I would go for the natural M/C. I have done it both ways and I will never do another D&C. It's not that they are bad, it just took a long time for my body to get back to normal.

Good luck hun.

3ltlones · July 2009

I am so sorry for your loss. I'm not sure what I would do in your situation. But, it sounds like you are more comfortable waiting. If you are unsure right now of going ahead with the D&C, it won't hurt for you to wait another week. Also, I would ask for another u/s just to be sure, because it will help with things. After the week is up then if you are comfortable you can go ahead with the D&C. Thinking of you.

SueandDan · July 2009

hi,

i'm really sorry you are going through this.

my situation is somewhat similar. my 10 week ultrasound revealed an empty sac. i had gone in to the triage b/c i had very light brown spotting and minor cramping - i just knew something was 'off'. the ultrasound revealed an empty sac. i was given the option of a d&c but decided to let it happen on its own. i'm really glad i did, b/c 4 weeks to the day of the ultrasound af came.

if you are unsure, maybe give it a week and sort out your thoughts?

i wish you all the best - hang in there!

someflower6 · July 2009

i just wanted to say i'm so sorry for your loss. the other girls gave really good answers in their posts, and i don't have much to add... i had a d&c and yeah, it sucked and there were some issues on getting back to normal, but i think i am now (only time will tell!). whatever your decision, we got your back.

pamiva1 · July 2009

I'm so sorry

I just went through a very similar thing. I just had my 2nd miscarriage, and this one was a b/o which was discovered at 6 weeks but miscarried at 11.

I also had serious reservations about a D&C. I know they are perfectly safe and there's no reason to worry, but I just was not ready for one yet. I waited 4 weeks to miscarry natually but when nothing happened my doctor recommended another option - cytotec (also called misoprostol). It's a medicine that softens your cervix and causes you to contract which most times will start the miscarriage. For me, it was the right decision because I was able to avoid the D&C and miscarry at home. It's can be painful, so if you choose this option be sure to ask for pain medication. My was completely managable with the pain meds.

Good luck with your decision. There's no wrong answer as long as you make it through this difficult time. If you have questions about the cytotec, I'm happy to answer them.

TravelinMama · July 2009

Some of the PP had some very good thoughts and advice. I just wanted to say sorry for your loss.

JohnAndLaurasBABY · August 2013

What do you mean by af came?

marsht · August 2013

I had a blighted ovum with my last loss- we opted for a d+C. Although the sac is empty they can still test the genetic material of the sac. They ran a FISH test (I think it was called) Ours came back as a genetically normal male.